Paracentral Acute Middle Maculopathy in Giant Cell Arteritis.

PURPOSE To report the occurrence of Paracentral Acute Middle Maculopathy (PAMM) in Giant Cell Arteritis (GCA), describe its features and outcome, and identify risk factors associated with PAMM in GCA patients. METHODS Review of medical records of patients with GCA who were examined in the Rothschild Foundation Hospital. Patients were divided in 3 groups: GCA with PAMM (group 1), GCA with ophthalmic involvement but without PAMM (group 2), and GCA without ophthalmic involvement (group 3). We analyzed the data in terms of age, gender, medical history, laboratory testing, visual acuity, and posterior segment vascular involvement. RESULTS Among the 96 patients who met the inclusion criteria, 52 had ophthalmic involvement, and 16 patients were included in group 1 (GCA with PAMM). In this subgroup, mean age was 81.6, and was found to be older than others groups. Visual prognosis was similar between groups 1 and 2. Of the 20 eyes with PAMM, 35% were also associated with homolateral anterior ischemic optic neuropathy. No statistical difference was found in term of initial symptoms, signs and laboratory testing. CONCLUSION PAMM are frequently observed lesions in ocular GCA. Patients can present with isolated findings of PAMM as the only indication of GCA. An OCT of the macula should be routinely performed in patients with suspected GCA, specifically if they complain of visual changes, to look for signs of ischemia in the middle layers of the retina. Isolated PAMM should raise suspicion for GCA in patients at risk.